How health system factors influence referral decisions in patients that may have cancer: European symposium report.

Michael Harris, Peter Frey, Magdalena Esteva, Svjetlana Gasparovic Babic, Mercè Marzo-Castillejo, Davorina Petek, Marija Petek Ster, Hans Thulesius

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Objective: To identify the system and other non-clinical factors that may influence a General Practitioners’ decision on whether to refer a patient who may have cancer. Study design: Expert group discussion and consensus formation.
Methods: A group of eight General Practitioner (GP) researchers from Croatia, England, Slovenia, Spain, Sweden and Switzerland used brainstorming to identify the non- clinical factors that could affect GPs’ decision-making when faced with patients that might have cancer. The group refined and came to a consensus on these factors.
Results: Many non-clinical factors are likely to have a significant impact on referral decisions. These include levels of gatekeeping responsibility, funding systems, access to special investigations, fear of litigation, and relationships with specialist colleagues.
Conclusions: Many patients with cancer present without red-flag symptoms, but nevertheless still cause a feeling of concern in their GPs. How a health system is organised is likely to influence on how GPs act on those concerns.
Original languageEnglish
Pages (from-to)7-10
Number of pages4
JournalJournal of Cancer Research & Therapy
Issue number1
Early online date11 Dec 2015
Publication statusPublished - 2016


  • Cancer
  • Primary Health Care
  • Decision making
  • Diagnosis
  • Health services

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